1. Vogt-Koyanagi Harada Disease
Fernando Oréfice
Juliana Lambert Oréfice
Centro Brasileiro de Ciências Visuais- Brazil

2. Ocular History
31 year woman
Sudden blurred vision from 2 days prior

3. First Presentation VA: OD 20/200, OS 20/400 Mild AC cell 1+/4+ Fundus:
Hyperaemia of disc
Exudative retinal detachment

4. Serous detachment
Hyperemia disk

5. Spectral OCT
Serous detachment
Serous detachment

6. Spectral OCT Posterior retinal irregular profile.
Macular serous detachment

7. Fundus fluorescein angiography
OD: disc hyperfluorescence OS pinpoint

8. Diagnosis Vogt-Koyangi Harada Disease Involvement of the optic nerve
very significant
justifies a more aggressive treatment.

9. Treatment Intravenous methyprednisolone 250mg IV, 6/6 hours, 3 days
followed by oral prednisone

10. Follow up - Week 9 VA: OD 20/20, OS 20/20 AC cell 0+/4+
Oral prednisolone

11. Follow up Week 9

12. Follow up Week 9

13. Follow up Week 9 OD: Baseline: Disc hyperfluorescence
Week 09: Normal fundus fluorescein
OS:
Baseline: Macular pinpoint

14. Follow up Week 9
Serous detachment
RPE line was reformed

15. Follow up Week 9
Serous detachment

16. Follow up Week 9 OCT Baseline: Macular serous detachment.
Week 9: RPE line was reformed

17. Conclusion
Early and aggressive high-dose systemic corticosteroid therapy has become the mainstay therapy of VKH disease.
Quick answer to the treatment
Patients with VKH disease adequately treated with corticosteroids have a favorable visual prognosis.